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  • Küçük Resim
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    Böbrek Yaralanmasını Taklit Eden Nadir Bir Renal Kolik Olgusu : Koç Toslaması Sonrası Gelişen Renal Kolik
    (Çanakkale Onsekiz Mart Üniversitesi, 2014) Sancak, Eyüp Burak; Reşorlu, Mustafa; Akbaş, Alpaslan; Gülpınar, Murat Tolga
    Hayvanlarla ilişkili travmalar, ciddi morbidite ve mortalite potansiyelinden dolayı, önemli bir tıbbi problemdir. Türkiyede hayvancılığın halen önemli bir geçim kaynağı oluşu, bu problemin riskini artırmaktadır. Koç saldırısı sonucu oluşan travma ile ilgili literatürde çok az veri vardır. Ancak hayvanla ilişkili travma sonrası renal kolik vakasına literatürde rastlanmamıştır. Biz burada genç erişkin bir hastada, koç saldırısı sonrası gelişen akut renal kolik olgusunu sunmayı planladık.
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    Öğe
    Böbrek Yaralanmasını Taklit Eden Nadir Bir Renal Kolik Olgusu: Koç Toslaması Sonrası Gelişen Renal Kolik
    (Çanakkale Onsekiz Mart Üniversitesi, 2014) Sancak, Eyüp Burak; Reşorlu, Mustafa; Akbaş, Alpaslan; Gülpınar, Murat Tolga
    Özet Hayvanlarla ilişkili travmalar, ciddi morbidite ve mortalite potansiyelinden dolayı, önemli bir tıbbi problemdir. Türkiyede hayvancılığın halen önemli bir geçim kaynağı oluşu, bu problemin riskini artırmaktadır. Koç saldırısı sonucu oluşan travma ile ilgili literatürde çok az veri vardır. Ancak hayvanla ilişkili travma sonrası renal kolik vakasına literatürde rastlanmamıştır. Biz burada genç erişkin bir hastada, koç saldırısı sonrası gelişen akut renal kolik olgusunu sunmayı planladık
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    Denizli ilinde ilköğretim çağındaki çocuklarda nokturnal enürezis prevalansı ve risk faktörleri
    (2013) Bolat, Deniz; Bolat, Elif; Sancak, Eyüp Burak; Başer, Aykut; Zencir, Mehmet; Sınık, Zafer
    Özet Amaç: Bu çalışmada Denizli ilinde ilköğretim çağındaki çocuklarda nokturnal enürezis prevalansını ve bu durumla ilişkili risk faktörlerini araştırmak amaçlanmıştır. Gereç ve yöntem: Çalışma için Denizli İl Milli Eğitim Müdürlüğünün 30/03/2005 tarihli ve 8820 sayılı onayı alınmıştır. Denizli il merkezinden 8, ilçelerinden 6 ilköğretim okulu randomize olarak seçildi. Ailenin sosyodemografik özelliklerini, çocuğun tıbbi özgeçmişini içeren sorgulama formu ile beraber işeme alışkanlıklarını sorgulayan İşeme Bozuklukları Semptom Skoru Anketi yaşları 7-14 arasında olan 2353 ilköğretim öğrencisi çocuğun ebeveynleri tarafından dolduruldu. Bilinen nörolojik ya da ürolojik hastalık öyküsü olan çocuklar araştırma dışı bırakıldı. İstatistiksel yöntemler olarak tanımlayıcı, analitik ve lojistik regresyon analizi kullanıldı. Bulgular: Araştırmaya katılım hızı %91,9du (2164 kişi). Nokturnal enürezis toplam prevalansı %19,2 olmakla birlikte bu oran ilerleyen yaşla beraber düşme eğilimindeydi. Çocuğun okul başarısı, ailenin sosyoekonomik seviyesi, ebeveynlerin eğitim düzeyi, babanın mesleği, pozitif aile öyküsü, gündüz idrar kaçırma, geçirilmiş idrar yolu enfeksiyonu öyküsü, kabızlık ve disfonksiyonel işeme semptomları nokturnal enürezis ile istatistiksel olarak anlamlı ilişki göstermekteydi (p<0.05). Erkek cinsiyet, erken yaş, annenin düşük eğitim seviyesi ve pozitif aile öyküsü nokturnal enürezis için bağımsız risk faktörlerini oluşturmaktaydı. Sonuç: Nokturnal enürezis, ilköğretim çağındaki çocuklarda sık görülen önemli bir sağlık sorunudur. Enüretik çocukların tedavileri planlanırken bu durumla ilişkili risk faktörleri göz önünde bulundurulmalıdır. Bu çalışma, Türkçe validasyonu yapılmış bir semptom skoru ile, Türkiyedeki ilköğretim çağındaki çocuklarda nokturnal enürezis prevalansını değerlendiren ilk kesitsel çalışmadır.
  • Küçük Resim
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    Determining the Stone Free Rate of Retrograde Intrarenal Surgery. Which Radiological Technique? RIRSearch Study Group
    (Elsevier Science Inc, 2024) Yazıcı, Cenk Murat; Gönen Korcan, Aysun; Ozman, Oktay; Çakır, Hakan; Başataç, Cem; Akgül, Hacı Murat; Çınar, Önder; Sıddıkoğlu, Duygu; Sancak, Eyüp Burak
    OBJECTIVE To evaluate the sensitivity and specificity of ultrasonography (USG) and kidney ureter bladder radiography (KUB) for the determination of stone-free status of retrograde intrarenal surgery (RIRS) according to different stone-free status definitions. MATERIALS AND METHODS The patients who underwent RIRS between September 2021 and September 2022 were prospectively included in the study. All patients underwent a KUB radiography, urinary system USG and noncontrast abdominal tomography at the postoperative first month of the surgery. The sensitivity, specificity, negative predictive factor, and positive predictive factor of USG and KUB on evaluating the stone-free rate were analyzed according to different stone-free status definitions. RESULTS A total of 178 patients were included in the study. The stone-free rates according to stone-free definitions as; residual stone < 4 mm, < 2 mm and no residual stone were 79.2%, 64.0%, and 56.7%, respectively. According to its definition as a residual stone < 4 mm, the sensitivity and specificity of USG were 64.9% and 84.3%, respectively. The sensitivity of USG was 57.1% and 52.5% as the definitions were residual stone < 2 mm and no residual stone, respectively. Addition of KUB to USG slightly increased the sensitivity but did not change the specificity. CONCLUSION USG had high specificity but low sensitivity for evaluating stone-free status after RIRS and addition of KUB did not increase the diagnostic efficacy. Although USG may be used in daily practice, it may overestimate the stone-free status and noncontrast abdominal tomography must be used during the clinical trials to document the exact stone-free rates of RIRS. (c) 2024 Elsevier Inc. All rights reserved.
  • Küçük Resim
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    Does extracorporeal shock wave lithotripsy before retrograde intrarenal surgery complicates the surgery for upper ureter stone? The results of the RIRSearch group
    (Wiley, 2021) Yazıcı, Cenk Murat; Sıddıkoğlu, Duygu; Çınar, Önder; Özman, Oktay; Başataç, Cem; Akgül, Murat; Sancak, Eyüp Burak; Önal, Bülent; Akpınar, Haluk
    Aims: To evaluate the effect of pre-RIRS ESWL on the efficiency and safety of RIRS in the treatment of proximal ureter stones. Methods: The patients in the study population were divided into two groups. Group-1 was composed of patients who had undergone ESWL for proximal ureter stones before RIRS and Group-2 was composed of patients who directly underwent RIRS without any prior ESWL. The clinical and demographic properties of the patients were analysed in the RIRSearch database. The operative outcomes, peroperative complications, postoperative complications, hospitalisation time and stone-free rates were compared between the groups. Results: There were 56 patients in Group 1 and 95 patients in Group 2. The demographic and clinical properties were similar between the groups. The stone-free rates, peroperative complications and postoperative complications were also similar between the groups; however, the fluoroscopy time was significantly higher in Group 1 (P =.043). The cut-off duration of 10 weeks between ESWL and RIRS had reasonable/favourable discriminating ability, with a 51% sensitivity and 88% specificity rate for stone-free status. Conclusion: Performing ESWL on the proximal ureter stones before RIRS did not change the efficacy and safety of RIRS. The time between the patient's last ESWL session and RIRS had a predictive value for stone-free status, but did not have any effect on complications. © 2021 John Wiley & Sons Ltd
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    Does the 5-Item Modified Frailty Index Predict Adverse Outcomes after Retrograde Intrarenal Surgery? A Case-Control Study by the RIRSearch Group
    (Mary Ann Liebert, Inc, 2025) Başataç, Cem; Şimşekoğlu, Muhammed Fatih; Teke, Kerem; Tuna, Mustafa Bilal; Çınar, Önder; Akgül, Hacı Murat; Özman, Oktay; Sıddıkoğlu, Duygu; Sancak, Eyüp Burak
    Objectives: We aim to assess whether severely frail patients have an increased risk of complications and worse surgical outcomes after retrograde intrarenal surgery. Methods: The data of 340 consecutive patients undergoing retrograde intrarenal surgery to treat upper tract urinary stones were analyzed retrospectively. The 5-item modified frailty index (mFI-5) was used to assess the frailty status. Using a cutoff value of score 2 in the mFI-5 score, patients were divided into two groups: patients with an mFI-5 score <2 were assigned to a non-frail (Group 1) group, and patients with an mFI-5 score >= 2 were assigned to a frail (Group 2) group. The patients' demographics, stone characteristics, operative outcomes, and complication rates were compared between the groups. The primary objective was to examine whether the surgical outcomes were much better in non-frail patients. Results: After matching confounding factors, Group 1 comprised 255 patients, and Group 2 comprised 85 patients. The baseline characteristics were similar between the groups. There were no statistically significant differences in terms of the median operation time and length of hospital stay among groups. There were no significant differences between groups for intraoperative complication rates (7.6% and 9.4%, respectively; P = .47) and postoperative complication rates (13.8% and 11.8%, respectively; P = .71), and stone-free rates (70.9% versus 72.9%, respectively; P = .73). Conclusions: Retrograde intrarenal surgery is an efficient and feasible treatment option for upper urinary tract stones in severely frail patients.
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    Enurezisli erişkin hastalarda biofeedback tedavisinin etkinliği
    (2016) Sancak, Eyüp Burak; Akbaş, Alpaslan; Alan, Cabir; Ersay, Ahmet Reşit
    Amaç: Çalışmanın amacı; primer monosemptomatik enurezisli (MsE) erişkinlerde, biofeedback tedavisinin etkinliğini araştırmaktır. Gereç ve Yöntemler: Prospektif dizaynlı bu çalışmada, primer MsE'li erişkin hastalar çalışmaya dahil edildi. Nörojen mesaneli, gündüz işeme problemi olan, anatomik anomalisi olan ve enurezisle ilişkili başka hastalığı olan hastalar çalışmaya alınmadı. Kriterlere uyan 13 hastanın demografik verileri kaydedildi. Biofeedback öncesinde ve tedavinin bitiminden sonra 3. ayda, hastaların enurezis sıklıkları, üroflovmetri değerleri, rezidüel idrar miktarları (PVR) ve total mesane hacmi (TMH) (işeme hacmi + PVR) değerlendirildi. Biofeedback tedavinin başarısı, ayda bir kez veya daha az gece ıslatması olarak tanımlandı. Bulgular: Altı erkek ve yedi kadını içeren toplam 13 hastanın yaş ortalaması 29.2 ± 8.2 idi. Biofeedback tedavisi öncesinde aylık enurezis sıklığı 23.4 ± 5.9 iken, tedavi sonrasında 5.2 ± 8.9 olarak hesaplandı (p=0.002). Biofeedback tedavisi öncesi ve sonrasında; PVR, maksimum idrar akım hızı (Qm) ve ortalama akım hızı (Qa) açısından fark saptanmadı. Biofeedback tedavisi sonrası, TMH'nin 277.8 ml'den 329.9 ml'ye yükseldiği belirlendi (p=0.001). Sonuç: Primer MsE olan erişkin hastalarda biofeedback tedavisi, güvenli basit ve kolay uygulanabilen bir tedavi seçeneğidir. Mesane kapasitesini artırdığı saptanan bu tedavi, bu özel hasta grubu için önerilebilir.
  • Küçük Resim
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    Factors affecting Urethral Catheter Placement Following Flexible Ureterorenoscopy: RIRSearch Study Group
    (Acıbadem Üniversitesi, 2024) Çakır, Hakan; Çınar, Önder; Akgül, Murat; Özman, Oktay; Başataç, Cem; Şimşekoğlu, Muhammed Fatih; Teke, Kerem; Sancak, Eyüp Burak
    Background/Purpose: To investigate the factors affecting UC placement following flexible ureterorenoscopy (fURS) and the effect of urethral catheter (UC) placement on patient quality of life. Methods: The present study was performed in prospective manner from 1st January 2015 to 30th December 2023, and patients with renal stones smaller than two centimeters who underwent fURS were analyzed for study inclusion. Patients’ demographic characteristics, operative parameters, success of procedure, complications, and VAS score were recorded. Patients were categorized into two groups according to UC placement or not. These groups were compared according to preoperative parameters, intraoperative data, complications, success and VAS at postoperative 6th hour. Results: In total, 324 patients were enrolled into the study. UC was inserted in 170 patients following fURS and was not inserted to 154 patients. In the patient group with UC placement, ratio of male patients (p= 0.002), ratio of anticoagulant use (p= 0.002), preoperative creatinine level (p=0.001), stone size (p= 0.001), stone burden (p= 0.001), and ratio of multiple stones (p= 0.001) were significantly higher. Operation time was significantly longer (p= 0.003) and intraoperative complications (p= 0.045) were significantly higher in patients with UC insertion. Need for additional analgesia and VAS score was significantly lower in patients without UC placement (p= 0.004 vs. p= 0.001). Multivariate analysis revealed that male gender, higher preoperative creatinine level, higher stone size and stone burden, and longer operation time were predictive factors for UC placement following fURS (p= 0.008, p= 0.001, p= 0.001, p= 0.010, and p= 0.001, respectively). Conclusion: The present study demonstrated that UC placement following fURS was associated with increased analgesia requirements and more pain. Moreover, our study demonstrated that male gender, higher preoperative creatinine level, higher stone size and stone volume, and longer operation time resulted in UC insertion after fURS.
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    The Impact of Stone Density on Operative Complications of Retrograde Intrarenal Surgery: A Multicenter Study with Propensity Score Matching Analysis
    (Mary Ann Liebert Inc., 2022) Başatac, Cem; Özman, Oktay; Akgül, Hacı Murat; Özyaman, Onur; Çınar, Önder; Can, Günay; Sancak, Eyüp Burak
    Background: The aim of the study was to evaluate the impact of stone density on operative complication rates in retrograde intrarenal surgery (RIRS). Materials and Methods: A total of 473 consecutive patients undergoing RIRS for the treatment of upper tract urinary stones were included. To adjust for baseline confounders, one-to-one propensity score matching was performed. After matching, the patients were divided into two groups according to stone density (low density [LD] group, ≤970 Hounsfield unit [HU]; high density [HD] group, >970 HU). The patients' demographics, stone-related features, stone-free rates, and intraoperative and postoperative complication rates were compared between the groups. The primary objective was to evaluate whether the intraoperative and postoperative complication rates were higher in patients whose stone density was greater than 970 HU. Results: After propensity score matching, 170 of 210 LD and 170 of 263 HD patients undergoing RIRS were included. The baseline characteristics did not differ significantly between the groups. There were no significant differences between LD and HD patients with respect to intraoperative (5.9% and 8.8%, respectively; P = .29), postoperative (10.6% and 15.3%, respectively; P = .14), and overall complication rates (15.2% and 21.1%, respectively; P = .16). Stone-free status was achieved in 143 patients (84.1%) in the LD group and 148 patients (87%) in the HD group; the difference was not statistically significant (P = .27). Conclusion: Our results show that RIRS is a safe and effective minimally invasive procedure for the treatment of upper urinary tract stones, even in HD stones.
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    Karyotipik bozukluk gösteren intratestiküler leyomiyom
    (2015) Gülpınar, Murat Tolga; Akbaş, Alpaslan; Sancak, Eyüp Burak; Aydın, Hatip; Reşorlu, Mustafa; Özkanlı, Sıdıka Şeyma
    İntratestiküler leyomiyom benign karakterli ve nadir görülen bir skrotal kitle sebebidir. Preoperatif klinik bulgular ile malign bir testiküler kitleden ayrımı mümkün olmamaktadır. Bu durum benign karakterdeki bir tümör nedeniyle testis kaybına yol açmaktadır. Klinik olarak malign-benign ayrımı yapılamayan şüpheli durumlarda peroperatif yapılacak frozen inceleme ile doğru tanı ve tedavi yapılabilir. Erkeklerde düz kas dokusu kaynaklı benign tümörlerde karyotipik anormallik görülmesi son derece ender bildirilen bir durumdur. Leyomiyom patogenezinin altında yatan moleküler mekanizmaların henüz anlaşılamamış olması saptanan karyotipik anomalilerin önemini arttırmaktadır.
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    Lower Pole Stones Are Associated with Low Stone-Free Rates in Retrograde Intrarenal Surgery: A Myth or Fact? - A Matched Case-Control Study from the RIRSearch Group
    (Karger, 2025) Şimşekoğlu, Muhammed Fatih; Ozman, Oktay; Çakır, Hakan; Teke, Kerem; Çınar, Önder; Akgül, Murat; Tuna, Mustafa Bilal; Sancak, Eyüp Burak; Sıddıkoğlu, Duygu
    Introduction: There are conflicting results in the literature regarding the efficacy of retrograde intrarenal surgery (RIRS) in lower pole stones. This study aimed to evaluate RIRS outcomes in lower pole stones by forming matched case-control groups. Methods: The data of 491 patients who were diagnosed with kidney stones and underwent RIRS were retrospectively included in the study. A total of 209 patients with lower pole stones (Group 1) and 282 patients with pelvic stones (Group 2) were matched at a 1:1 ratio in terms of stone burden, stone density, preoperative double-J stenting status, and a previous history of shock wave lithotripsy, yielding 159 patients in each group. A computed tomography scan was performed to evaluate the stone-free status. The primary outcome was stone-free status 1 month after RIRS. Results: After case-control matching, the median age was 49 years (interquartile range [IQR]: 40-58) in Group 1 and 50 years (IQR: 35-60) in Group 2 (p = 0.388). The median stone burden values of Group 1 and Group 2 were 415.3 mm3 (IQR: 176.1-858.2) and 503.3 mm3 (IQR: 282.5-864), respectively (p = 0.100). After RIRS, stone-free status was achieved by 126 of the 159 (79.2%) in Group 1 and 133 of the 159 (83.6%) patients in Group 2 (p = 0.387). The groups were similar in terms of perioperative complications (4.4% in Group 1 and 3.8% in Group 2, p = 0.777), postoperative complications (13.8% in Group 1 and 10.3% in Group 2, p = 0.393), and median operation time (60 min in both, p = 0.230). A longer median fluoroscopy time was noted in Group 1 compared to Group 2 (26 s and 3 s, respectively, p = 0.013). Conclusions: Stone-free rates and complications were comparable between the patients with lower pole and pelvic stones after RIRS. However, lower pole stones are associated with longer fluoroscopy time. RIRS can be performed effectively for the treatment of lower pole stones.
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    Multi-aspect analysis of ureteral access sheath usage in retrograde intrarenal surgery: Results of propensity score matching study
    (Elsevier, 2021) Özman, Oktay; Akgül, Hacı Murat; Basatac, Cem; Çınar, Önder; Sancak, Eyüp Burak; Yazıcı, Cenk Murat; Önal, Bülent; Akpınar, Haluk
    The aim of this study is to evaluate the effect of ureteral access sheath (UAS) use and calibration change on the success and complications of retrograde intrarenal surgery (RIRS)
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    P358 - Which is a better predictor for the safety and efficacy of retrograde intrarenal surgery; stone size or volume? A study of rirsearch study group
    (Elsevier, 2024) Yazıcı, C. M.; Sıddıkoğlu, Duygu; Özman, O.; Çınar, O.; Akgül, H. M.; Çakır, H.; Başatac, Cem; Sancak, Eyüp Burak
    [Anstract Not Available]
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    Prediction of Possible Factors that Affect Stone Free Rate of Retrograde Intrarenal Surgery; A Multicenter Study
    (Tekirdağ Namık Kemal Üniversitesi, 2020) Özman, Oktay; Başataç, Cem; Akgül, Murat; Çınar, Önder; Sancak, Eyüp Burak; Yazıcı, Cenk Murat; Onal, Bulent
    Objective: The aim of the study was to evaluate possible factors predicting stone-free status at retrograde intrarenal surgery for renal stones. Material and Method: A retrospective multicenter study was performed using data from 513 patients treated between February 2016 and January 2020 at four referral centers in Turkey. The patients were divided into two groups whether they had no residual stone over 3 mm (Group 1) or not (Group 2). Pre and peroperative parameters were compared in both groups (Table 1). Univariate and multivariate analyzes were performed to identify any factors affecting the stone-free rate (Table 2). Results: Overall stone-free rate was 88.5% (454/513). Lower calyx stones and multipl stones were significantly higher in Group 2 (p=0.006, p=0.02, respectively). Also access sheathless procedure rate was significantly higher and the basket catheter useage rate was significantly lower in Group 2 (p=0.04, p [TR] Amaç: Bu çalışmanın amacı Retrograd İntrarenal Cerrahi’de taşsızlığı öngören olası faktörleri araştırmaktır. Materyal ve Metod: Şubat 2016-Ocak 2020 tarihleri arasında Türkiye'deki dört ayrı merkezde tedavi edilen 513 hastanın verileri kullanılarak retrospektif çok merkezli bir çalışma gerçekleştirildi. Hastalar 3 mm'nin üzerinde rezidü taş saptananlar (Grup 1) ve rezidü taş saptanmayanlar (Grup 2) olmak üzere iki gruba ayırıldı. Pre ve peroperatif parametreler her iki grupta karşılaştırıldı (Tablo 1). Taşsızlık oranını etkileyen faktörleri araştırmak için univariate ve multivariate analizler yapıldı (Tablo 2). Bulgular: Toplam taşsızlık oranı % 88.5 idi (454/513). Alt kaliks taşları ve multipl taşlar Grup 2'de anlamlı olarak daha yüksekti (sırasıyla p = 0.006, p = 0.02). Ayrıca erişim kılıfsız prosedür oranı Grup 2'de anlamlı olarak yüksek ve basket kateter kullanım oranı anlamlı olarak düşüktü (sırasıyla p = 0.04, p
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    Prevalence of Daytime Urinary Incontinence and Related Risk Factors in Primary School Children in Turkey
    (Korean Urological Assoc, 2014) Bolat, Deniz; Acar, İsmail Cenk; Zümrütbaş, Ali Ersin; Eskiçorapcı, Saadettin; Sancak, Eyüp Burak; Zencir, Mehmet; Turan, Tahir
    Purpose: Urinary incontinence is one of the major urinary symptoms in children and adolescents and can lead to major distress for the affected children and their parents. In accordance with the definitions of the Standardization Committee of the International Children's Continence Society, daytime urinary incontinence (DUI) is uncontrollable leakage of urine during the day. The aim of this cross-sectional study was to investigate the prevalence and associated risk factors of DUI in Turkish primary school children. Materials and Methods: The questionnaire, which covered sociodemographic variables and the voiding habits of the children, was completed by the parents of 2,353 children who were attending primary school in Denizli, a developing city of Turkey. The children's voiding habits were evaluated by use of the Dysfunctional Voiding and Incontinence Symptoms Score, which is a validated questionnaire. Children with a history of neurological or urological diseases were excluded. Results: The participation rate was 91.9% (2,164 people). The overall prevalence of DUI was 8.0%. The incidence of DUI tended to decrease with increasing age and was not significantly different between genders (boys, 8.8%; girls, 7.3%; p=0.062). Age, maternal education level, family history of daytime wetting, settlement (urban/rural), history of constipation, urinary tract infection, and urgency were independent risk factors of DUI. Conclusions: Our findings showed that DUI is a common health problem in primary school children. In an effort to increase awareness of children's voiding problems and the risk factors for urinary dysfunction in the population, educational programs and larger school-based screening should be carried out, especially in regions with low socioeconomic status.
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    Protective effect of metformin on lithium-induced nephrogenic diabetes insipidus: An experimental study in rats
    (Wroclaw University of Medicine, 2021) Taş, Halil İbrahim; Sancak, Eyüp Burak
    Background. Lithium is widely used in the treatment of bipolar disorders and may lead to nephrogenic diabetes insipidus (NDI), following long-term treatment. Metformin is considered the preferred initial therapy for patients with type 2 diabetes mellitus (T2D). Objectives. To investigate the protective effect of metformin on the kidney damage caused by lithium administration. Materials and methods. Using an animal model of chronic lithium-induced NDI, rats were divided into 4 groups: sham, metformin, lithium, and lithium + metformin. The effects of these treatments were examined using serum electrolytes, blood and tissue total antioxidant status, total oxidant status, the oxidative stress index, urine and blood osmolality, and tissue aquaporin-2 (AQP2) levels. Additionally, histopathological changes, including congestion, hydropic swelling, tubular necrosis, tubular atrophy, and Bowman’s capsule dilatation, were evaluated. The total histopathological score was obtained by summing the scores for each pathological finding. Results. In the lithium group, biochemical variables indicating NDI, including sodium, chloride and blood osmolality, increased, and urine osmolality decreased, compared to the sham group. With metformin treatment, the blood osmolality decreased from 328.17 mOsm/kg to 306.33 mOsm/kg, and urine osmolality increased from 349.67 mOsm/kg to 754.50 mOsm/kg (p = 0.004 and p = 0.001, respectively). Tissue AQP2 levels decreased with lithium administration but stabilized with metformin treatment. Additionally, in comparison to the lithium group, the total histopathological score in the metformin group declined from 8.0 to 2.0 (p = 0.002). Conclusions. Metformin may help protect the kidneys from lithium-induced NDI through the AQP2 regulating effect and a reduction in oxidative stress.
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    Safety and Efficacy of Retrograde Intrarenal Surgery in the Solitary Kidney: A Propensity Score-Matched Analysis of the RIRSearch Study Groups' Results
    (Mary Ann Liebert, Inc, 2024) Çınar, Önder; Çakır, Hakan; Ozman, Oktay; Akgül, Murat; Başataç, Cem; Sıddıkoğlu, Duygu; Sancak, Eyüp Burak
    Background: The aim of this study was to evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) in patients with renal calculi with solitary kidneys (SKs). Materials and Methods: In this retrospective, multicenter study, a matched case-control study was carried out using the data from 522 RIRS patients treated between 2014 and 2021. Patients' demographic data, stone characteristics, operative outcomes, perioperative and postoperative complications, and surgical success were analyzed. All patients were evaluated with noncontrast-enhanced computed tomography (NCCT) preoperatively and 1 month after the surgery. Surgical success was defined as no evidence of remaining residual fragments of <3 mm in the first-month postoperative NCCT images. The case group of 29 patients with SKs (Group 1) treated with RIRS were matched with 76 control patients (Group 2) with bilateral kidneys, who underwent unilateral RIRS by propensity score-matched (PSM) analysis. Results: After PSM analysis, the demographic and clinical data did not differ significantly between the groups. The stone burden was similar between the groups: 733.6 mm3 (range: 50.4-7565.9) versus 991.1 mm3 (range: 201.2-4380.6) (P = .09), respectively. The perioperative complication rates were 13.8% (n = 4) in Group 1 and 11.8% (n = 9) in Group 2 (P = .78). There was no statistically significant difference between the groups for postoperative complication rates (minor complications, classified as Clavien 1 or 2), (6.9% [n = 2] versus 13.2% [n = 10; P = .34]), respectively. Surgical success was 82.8% (n = 24) in Group 1 and 83.6% in Group 2 (P = .92). There was no significant difference between preoperative and postoperative glomerular filtration rate and creatinine values (P = .005). Conclusions: Our results support that RIRS is a safe and effective treatment method in SK patients with similar complication and stone-free rates compared to patients who had bilateral functional kidneys and underwent unilateral RIRS.
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    Standardizing the Stone Free Definition After Retrograde Intrarenal Surgery
    (Elsevier Science Inc, 2024) Yazıcı, Cenk Murat; Gönen, Korcan Aysun; Ozman, Oktay; Çakır, Hakan; Başatac, Cem; Akgül, Hacı Murat; Çınar, Önder; Sıddıkoğlu, Duygu; Sancak, Eyüp Burak
    [Anstract Not Available]
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    The effect of optical dilatation before retrograde intrarenal surgery on success and complications: Results of the RIRSearch group study
    (Wiley, 2021) Sancak, Eyüp Burak; Başataç, Cem; Akgül, Hacı Murat; Çınar, Önder; Özman, Oktay; Yazıcı, Cenk Murat; Akpınar, Haluk
    Aim The guidelines propose optical dilatation before retrograde intrarenal surgery (RIRS), but there are currently no evidence-based studies concerning the impact of optical dilatation with semirigid ureteroscopy (sURS). The aim of this study was to evaluate the effect of optical dilatation through sURS prior to the RIRS procedure on the success and complications of RIRS. Methods A total of 422 patients were included in the retrospective multicentre study. The patients were divided into two groups according to whether sURS was to be performed. Patients' demographics, stone parameters and operative outcomes were compared. Surgical success was defined as no or up to 3-mm residual stone fragments without the need for additional procedures. The independent predictors for surgical success were determined with a multivariable logistic regression model. Results Of the 422 patients, 133 (31.5%) were in the sURS group and 289 (68.5%) were in the non-sURS group. Stone characteristics and patients' demographics were similar between the groups. Operation time in the sURS group was significantly longer (compared with the non-sURS group, P < .0001). A ureteral access sheath (UAS) could not be placed in four (3.0%) patients in the sURS group, nor in 25 (8.7%) patients in the non-sURS group (P = .03). Compared with the non-sURS group, the intraoperative complication rate was lower in the sURS group (14 [4.8%] vs 1 [0.8%], P = .04). The surgical success rate was higher in the sURS group (P = .002). Nevertheless, sURS had no independent effect on surgical success. We found two independent predictors for surgical success rate: stone number (P < .0001, OR:2.28) and failed UAS placement (P = .035, OR:3.49). Conclusions Optical dilatation with sURS before RIRS increases surgical success by raising the rate of UAS placement and reducing the rate of intraoperative complications. We suggest that this method can be routinely applied to patients who have not been passively dilated with a JJ stent.
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    The Effect of Reusable Flexible Ureteroscope Aging on the Efficacy and Safety of Retrograde Intrarenal Surgery
    (Mary Ann Liebert, Inc, 2024) Yazıcı, Cenk Murat; Çakır, Hakan; Ozman, Oktay; Başataç, Cem; Akgül, Hacı Murat; Çınar, Önder; Sıddıkoğlu, Duygu; Sancak, Eyüp Burak
    Purpose: Reusable flexible ureteroscopes may lose their mechanical functionality through overuse, which is known as aging of the flexible ureteroscope. Although mechanical deterioration has been shown in several studies, the data about the effect of this situation on the efficacy and safety of retrograde intrarenal surgery (RIRS) are missing. The aim of our study was to evaluate the effect of the aging of flexible ureteroscopes on the efficacy and safety of RIRS.Methods: Patients who had undergone RIRS between 2017 and 2021 at a single center were retrospectively included in the study. Serial surgeries were performed using the same reusable flexible ureteroscope (Storz X2) until it was broken or malfunctioned because of the aging process. Group 1 was formed by the first 10 cases on whom the flexible ureteroscopes were used, representing the youngest period of the instruments, whereas group 2 was composed of the last 10 cases on whom the flexible ureteroscopes were used, representing the oldest phase of the instruments. The operative and postoperative data-including the operation time, hospitalization time, intraoperative complications, postoperative complications, and stone-free rates-were compared between the two groups.Results: A total of five flexible ureteroscopes were included in the study. The number of cases for each flexible ureteroscope ranged between 87 and 133, with a median number of 107 cases. The demographic and clinical properties of patients in both groups were similar. The operation time, lasering time, and total laser pulse were similar between the groups. The stone-free rates in group 1 and group 2 were 82.0% and 78.0%, respectively (p = 0.304). The complication rates were also similar between the groups (p = 0.591).Conclusion: The aging of reusable flexible ureteroscopes did not negatively affect the efficacy and safety of RIRS. Therefore, surgeons may use the reusable types of flexible ureteroscopes until they are totally broken.